Caregiving is often a task that enters your life in a big way at a single moment in time. One day things are fine; the next you are forced to make big changes to accommodate this new reality.
And while the change in lifestyle plays a huge part of the process, another enters almost equally as fast: the cost. How are you going to afford this new lifestyle, when every piece seems to cost more and more? Between doctors, medicine and care, there simply isn’t enough in the checking account to cover it all.
Medicare is a health insurance plan that is funded by the government and covers people over the age of 65. If the person you are caring for has reached this age, chances are they are receiving the benefits. In some cases, people under the age of 65 can also receive benefits if they have needed disability benefits for 24 months or longer.
Medicare is divided into parts A, B and D. Part A is known as the hospital insurance. Part B is the supplemental insurance. Part D was added later, and is provided only by private insurance companies, which will cover specific drugs.
Part A provides coverage for inpatient hospital care as well as part of the medical items needed for a patient suffering from Alzheimer’s or dementia. It will cover up to 90 days in a hospital due to a temporary illness. If more time is needed, Part A also has a Lifetime Reserve of an additional 60 days that can be used one time. These temporary stays are considered acute care, and will include skilled nursing home care, hospice care, and home health care.
Part B covers a variety of things, including:
• Durable medical equipment
• Diagnostic xrays
• Outpatient hospital services
• Physicians services
• Mental health services
• Lab tests
• Physical, speech and occupational therapies
• Home health care services
Part D covers medications, and is purchased through a private insurance company. There are some limitation on this program such as a limit to the quantity of a drug you can receive, or the restriction of paying for a more expensive drug when an alternative “generic” is available and and is deemed to work just as well by a physician.
And now there is also Medicare Advantage Special Needs Plans – Part C. There are three types of SNPs – Chronic Care for people with certain severe or disabling conditions, Institutional Care for those living in a nursing home or require care at home, and Dual Eligible for people that qualify for both Medicare and Medicaid. If you fall into one of these care needs, you may qualify for the additional coverage, currently offered by a select number of insurers.
The enrollment period for a Medicare Advantage SNP is the same as the enrollment period for any other Medicare Advantage plan. The Annual Election Period runs from October 15 to December 7. However, there is special considerations for when a person approaches their 65th birthdays, and when your health conditions change, such as a recent diagnosis with a severe or disabling condition, as you enter a nursing home, or in cases where you move in or out of a network area.
If you’ve recently entered a caregiving role, this new process can be confusing, especially as you are determining what is covered and what isn’t. Your best course of action is to start by reviewing the Medicare website. Then contact a specialist to understand more of what benefits are coming to you and the person you are caring for.